Abstract
The aim of this study was to evaluate the yield of EBUS-TBNA in the diagnosis of granulomatous lymph nodes.
Patients and methods: All patients, from October 2005 to October 1010 in Hospital U Germans Trias I Pujol (Badalona) and Hospital U La Fe (Valencia), with hilar or mediastinal granulomatous lymph nodes were collected. Diagnosis of sarcoidosis was established based on clinical and radiological findings, supported by histologic evidence of noncaseating epithelioid-cell granulomas in the absence of necrosis or organismt. Diagnosis of tuberculosis (TB) was made by the presence of necrotizing granulomas with exclusion of other granulomatosis or cultivation of Mycobacterium tuberculosis (MTB).
Results: 34 patients were diagnosed: 15 sarcoidosis, 16 TB, 1 silicosis, 1 sarcoidosis-like, and 1 with HIV infection and reconstitution of inmune response syndrome with granulomatous lymphadenitis. Sarcoidosis patients had a average age of 49 years, 9 males.9 had suspect sarcoidosis and everyone had mediastinal and/or hilar lymphadenothies and 5 showed lung nodules. 36 lymph node stations were explored (average 2.4) and was punctured station 7 (15 times) and 10 L (6). EBUS-TBNA was decisive in 10 cases. TB mean age was of 49 years, 12 males and 2 HIV. 8 had prior suspicion of TB, 6 with PPD skin test + and 6 showed also lung injuries. 44 lymph nodes stations were explored (average 2.8), the more punctured was stations 7 (14 times) and 4R (10). Necrosis was found in 9 cases and in 6 culture of MTB was positive and EBUS-TBNA was decisive in 9 cases. There were no complications of the technique.
Conclusion: EBUS-TBNA is a safe and cost effective diagnostic method that was decisive in involvement with granulomatous disease.
- © 2011 ERS
